Center Profile: Boris Pasche, M.D., Ph.D.

Web Extra! Hear Dr. Pasche describe how a link between obesity and colon cancer could lead to new treatments!

Crossroads salutes Boris Pasche, M.D., Ph.D., the UAB Comprehensive Cancer Center’s newly appointed director of hematology and oncology and associate director for translational research. A specialist in breast and colon cancer genetics, Dr. Pasche is internationally recognized for his basic science and clinical research and has recently published results of a study revealing a link between obesity and colon cancer.              

The summer of 2008, the first summer in Birmingham for Boris Pasche, M.D., Ph.D., was a relatively mild one for the region. Still, it was a good 20 degrees warmer than Chicago, where he had been an associate professor in Northwestern University’s Division of Hematology and Oncology, and a good 40 degrees warmer than his native Switzerland, where he began his medical training.            

Born and raised in Lausanne, in the southwestern, French-speaking area of Switzerland, Dr. Pasche entered medical school in the shadow of the Savoy Alps. An exchange program brought him, after three years at the University of Lausanne, to the Karolinska Institute in Stockholm, Sweden, where he earned his M.D. and his Ph.D. and discovered a passion for research.            

“After that, I was faced with the dilemma of staying in Sweden or going back to Switzerland,” Dr. Pasche says. In Europe, he explains, the medical system is simply not set up to accommodate doctors who aspire to be both physicians and researchers. “What really attracted me to the U.S. was the fact that I could be a clinician-scientist. This path is not only encouraged but really considered to be the golden path.”            

That path sent him across the Atlantic for postdoctoral training at Harvard University, a residency at Cornell Medical Center and a fellowship at New York’s Memorial Sloan-Kettering Cancer Center. “I wanted both aspects: to see patients and be able to translate discovery into intervention that would ultimately benefit those patients,” he says.            

While he was in New York, Dr. Pasche met the anesthesiology intern from North Carolina who would become his wife, Valerie. Today the Pasches are the parents of 11-year-old Samuel and five-year-old Sarah, who enjoy soccer, tennis and learning to speak both their father’s native French and their mother’s native English.  

Doctor Without Borders
Dr. Pasche says his international background provides a unique perspective on different health-care systems. “Europe has better coverage of the population, where essentially nobody is left behind,” he notes. “At the same time, it’s a much less stimulating environment” where more readily available care has come at the expense of discovery and innovation in medicine.            

“The U.S. has more of a self-made population that says, ‘Anything we get, we have to pay for, and we have to earn,’” he says. “In these two different philosophies, nobody is right or wrong. They have just evolved differently.” He praises the U.S. for its success in academic medicine and its leadership in medical research and discovery.              

It was in the U.S., during his fellowship at Sloan-Kettering, that Dr. Pasche began exploring the field of cancer genetics. Working in the lab, he discovered a mutation in a gene that turned out to be a tumor-susceptibility gene. “I realized that if we can identify which genes are involved in these cancers, we might be able to make a difference,” he says, “both in picking up these diseases early and in treating them when patients carry the genetic alteration.”            

That’s important, he says, because between 20 and 30 percent of breast-cancer cases are inherited, and it may be as high as one-third of all colorectal-cancer cases. While those genetic links are the most readily apparent, Dr. Pasche says that genetic components can be found in every kind of tumor, which means cancer genetics research has applications throughout the field of oncology.

Tailored Therapies            
In fact, Dr. Pasche predicts that those genetic components will lead to the advent of “personalized medicine”—treatments designed around the patient’s specific genetic makeup to target cancer with the greatest possible accuracy. “With the dramatically improved techniques we have to look at genes,” he says, “it is likely that you’ll be able to sequence the entire genome for an individual for less than $1,000 within the foreseeable future.”            

Knowledge of cancer genetics is rapidly evolving, Dr. Pasche says. Oncologists already know that some features of a breast or colon tumor may predict how well a patient will react to various types of chemotherapy or biological therapy. “We’re probably going to move from a standard therapy for all breast or colon or gastric cancers to individualized therapies, which will probably be less toxic and more specifically targeted to patients with a specific type of tumor,” he says. Dr. Pasche adds that developments and discoveries in diagnosis and treatment will be led by centers with a tradition of phase-I and phase-II clinical trials, high patient volume, and teams of physician-scientists—centers such as UAB.            

Finding Inspiration            
“What brought me to UAB is a combination of several factors,” Dr. Pasche says. “First of all, UAB has a very strong reputation in the field of oncology. I was moving to a place that I knew had all the necessary infrastructure to be among the top centers.            

“The second thing is the fact that UAB has a very strong research environment, offering an opportunity to really expand any medical discovery at both the basic-science and clinical levels. UAB is strong in both.” Dr. Pasche says he derives both motivation and insight for his research from treating patients. “For me it is an inspiration that is renewed whenever I go back into the clinic and see patients,” he says. “Medicine, and oncology in particular, is my passion.”

Other passions for Dr. Pasche include running, swimming, windsurfing and yoga. He also harbors a love for deep-snow skiing, a hobby he embraced during his youth in Switzerland. “I lived close to the mountains until I left for Sweden and the U.S., and I’ve kept skiing,” he says. The mild Birmingham weather is likely to make that a challenge, but he and his family are not complaining: “I would say that after the harsh winter we had in Chicago, the prospect of spending winters in a milder environment is a plus.”